| NPI | 1164047429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1434970621) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2021-06-29 |